Advice on selecting medical school

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Dave1
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Advice on selecting medical school

Post by Dave1 »

I was wondering if anyone had any thoughts on financial criteria for choosing a med school. There's the cost of attendance of course (tuition, scholarships, living expenses etc. etc.). What I don't know much about is how the choice of school plays into future decisions and outcomes, such as residency, specializations and the biggie, future income potential. I found one thread in the archives about deciding between Harvard and Penn which provides some good info. However they are pretty comparable schools, and I'm looking across a wider range within the top 20, plus also looking at a state school with a semi-free ride. Given the high level of standardization of the MD curriculum, I don't think there isn't a huge difference in the quality of edu whether the school is rated top, mid or low tier, but what I am having a tougher time understanding is the difference after graduation if any. Your input appreciated.
-Dave
ETA: In light of some of the comments (thanks!) just wanted to clarify that we're only considering MD-granting schools within the continental US.
Last edited by Dave1 on Sat Mar 01, 2014 10:20 am, edited 1 time in total.
DTSC
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Re: Advice on selecting medical school

Post by DTSC »

If you want to go into academia, go to a famous school. If you don't, go to the cheapest school.

What do they call the guy who finishes last in the med school class? Doctor.
obgraham
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Re: Advice on selecting medical school

Post by obgraham »

What DTSC says.

Residency is a more important choice, but even there, 5 years into a nonacademic practice, nobody will give a rat's patootie where you went to school or residency.
Big Worm
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Re: Advice on selecting medical school

Post by Big Worm »

Physician here. As long as it is halfway decent, go to the cheapest one. No bones about it.
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Dave1
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Re: Advice on selecting medical school

Post by Dave1 »

Wow, quite a consensus there. Interesting, thanks. We're picking up some of the living expenses but she's getting loans for the rest so we're trying to make an informed decision here. And regarding academia, no probably not.
DTSC
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Re: Advice on selecting medical school

Post by DTSC »

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Tozmo
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Re: Advice on selecting medical school

Post by Tozmo »

I'm a doctor. Apply to MD and DO in the US. If you get into an MD school, go, regardless of cost. If not, go into DO cheapest available.

Now that the ACGME and AOA merged, DO post-training quality issues "should" be less of a problem going forward. This match will be interesting from the perspective that it may be a tipping point of American MD students not having enough spots to match into. Being a DO doesn't brand you as "an MD reject". In the end, a DO can write for as many vicodin/opana as an MD can and is reliant on the same Press-Ganey.

That being said, a lot of GME seems to see writing on the wall for FMG (Caribbean) students. Right now rotations for Caribbean schools can be difficult. The future of GME will probably follow suit. Be wary of going south; particularly if you want a specialty or non-FM/IM.

If you get into your two top dream schools, going to the cheapest isn't really that big of a deal, unless the tuition difference is 30k. The biggest trick is going to be NOT taking out max student loans. Some of my friends took out the maximum allowed and now owe big. I took minimal.

If you don't want to be an attending at the University of whatever filling out NIH grants, then school doesn't matter. If you want to be in academics at a more community setting, then residency is more important. Getting into residency is primarily based on your board scores, no matter what anyone tells you. GPA doesn't matter as much. The ERAS filter that is first applied is almost always based on your USMLE/COMLEX.

PS, read the WCI book. And then memorize First Aid.
obgraham
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Re: Advice on selecting medical school

Post by obgraham »

I agree about the DO schools. Though as an MD, I had a natural bias against them, circumstances led my daughter into a DO school. The curriculum is virtually identical, the standard testing is identical, and the clinical training is the same. She got a great residency, where she was the only DO among 15 MD's, and now she is an attending at a large metropolitan emergency dept. DO degree didn't hold her back one bit. I know a lot of DO's personally, and I can't see any deficiency in their qualifications.

However: many of the DO schools have arisen lately, to fill the need for more primary care docs. And many of these new schools are "for profit", with tuition as high or higher than the most prestigious med schools. Check into the costs very carefully.

Start with your own state med schools. Seldom is that a poor option, and I bet it is always the least expensive.
letsgobobby
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Re: Advice on selecting medical school

Post by letsgobobby »

I got into three good med schools, and chose the (by far) cheapest one, though it was still a top 10-15 school. It cost me $6500 per year in tuition in the late 90s. It was one of the most favorable financial decisions I have made. My total med school debt was about $7000 when I graduated in 1999.

That said I knew I wasn't interested in research, academics, or any competitive specialties. As a result the 'name' didn't matter the most, and I was able to get into a very good residency program. If I were interested in something very competitive I might have chosen differently.
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White Coat Investor
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Re: Advice on selecting medical school

Post by White Coat Investor »

Cheapest one you can get in to. There is a significant difference between US MD schools and US DO schools, and a significant difference between the two types of US schools and the Caribbean schools. But it turns out that the US MD schools are cheaper on average anyway. You can be a good doctor attending any of those, but it'll be a little bit more of an uphill battle in the less prestigious categories. Your state medical school is usually your best bet to get in, and to keep costs down.
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Bmac
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Re: Advice on selecting medical school

Post by Bmac »

Agree with all the above. Two biggest factors in your future financial situation and income will be size of student loan debt upon completing medical school and ultimate choice of specialty in residency. If you end up with a lot of the former you might really regret it if you end up in the lower paying specialties such as primary care.
newdumbdoc
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Re: Advice on selecting medical school

Post by newdumbdoc »

The name of your med school doesn't matter. It's all about board scores, how good you look on paper and how well you interview for residency.
kdub
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Re: Advice on selecting medical school

Post by kdub »

I am a 4th year medical student at a US allopathic school. My thoughts come from the vantage point of someone who just finished the residency interview process, and will graduate with an average student loan debt.

1) Going to a US allopathic school should be your top priority. DOs are equivalent in training and ability, but their opportunities for residency are NOT equivalent. Your chances of getting into a competitive (almost interchangeable with "lucrative") specialty will be MUCH better as an MD. There is a very real bias in the medical community, and that is just the world you live in.

2) Prestige differences between US allopathic schools will have no impact on your future earnings potential. A prestigious medical school will get you a prestigious residency program (within your chosen specialty), which gets you a prestigious fellowship, which gets you a prestigious academic faculty appointment. This is not where the money exists in medicine.

The best FINANCIAL move you can make is going to the cheapest US allopathic medical school to which you are accepted, then choosing a lucrative specialty (Derm, Rads, Ortho, etc) and going into private practice. Of course, there are more important things in life than maximizing income. Don't forget that.
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Joe S.
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Re: Advice on selecting medical school

Post by Joe S. »

I am a radiologist, and I graduated in 1985, so my advice may be somewhat out of date. In the first part of medical school, you are getting similar curricula, but some medical schools have better lecturers than others. In the later years, you will be going out into hospitals, and there is great variability on how good the teaching is out in the hospitals.

If you are going into a specialty like radiology, what medical school you go to can make a difference. It is a lot easier getting into a radiology residency if you come from Harvard rather than Podunk State. If you are going to be a general practitioner, internist, or pediatrician this is less important.

When I graduate in 1985, it was next to impossible for a DO to get into radiology. However, DO's are respected more now, and I do see rare DO's getting accepted into radiology residencies.
Big Worm
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Re: Advice on selecting medical school

Post by Big Worm »

kdub wrote: The best FINANCIAL move you can make is going to the cheapest US allopathic medical school to which you are accepted, then choosing a lucrative specialty (Derm, Rads, Ortho, etc) and going into private practice. Of course, there are more important things in life than maximizing income. Don't forget that.
Of course private practice opportunities may be pretty scant by then unfortunately, but that's a whole other discussion.
am
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Re: Advice on selecting medical school

Post by am »

Agree with cheapest med school. This will not put as much pressure on you when you are selecting specialty and practice location. 8 years into practice can not remember the last time someone asked me where I went to med school or residency. Income will be a function of if you go into private practice and how you work.

Radiology job market is poor right now so competition to get in is lower representing a major change from 2000-2007. Think DOs can be successful right now.
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Re: Advice on selecting medical school

Post by White Coat Investor »

You know, I actually do get asked where I went to medical school from time to time. I give them the name of the local state med school (has a good rep and known to be quite competitive, at least around here) and they nod in approval.
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AnesBH
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Re: Advice on selecting medical school

Post by AnesBH »

I reflect what others have written- choose the cheapest and don't look back. I work private practice with Caribbean trained MD's, several DO's, docs from Harvard, Princeton, state schools, etc, etc- no one cares about that only whether they're competent or not (which certainly doesn't depend on their school). It's the role you play in the end and your social skills that determine your coworkers perception of you. Just study hard, make the grade, and get along.

Also, pick up EmergDocs book "The White Coat Investor". I read it last weekend and it's full of info I wish I had when I was at your stage in the game. A fantastic read!
Last edited by AnesBH on Sat Mar 01, 2014 6:25 pm, edited 1 time in total.
Topic Author
Dave1
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Re: Advice on selecting medical school

Post by Dave1 »

This is great. I appreciate all the advice! And thanks for the book reco as well.
moshe
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Re: Advice on selecting medical school

Post by moshe »

I interjected a question that was not related to the OP so i removed it.

Apologies to the OP.
~Moshe
Last edited by moshe on Sat Mar 01, 2014 6:18 pm, edited 1 time in total.
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clp21
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Re: Advice on selecting medical school

Post by clp21 »

MD resident perspective...

Go to the cheapest school, residency matters most and you can get into almost any residency from almost any MD school with the right away rotations/letters/grades/USMLE scores

2nd the notion that DOs may be equally qualified but are not viewed equally when it comes to competitive residency programs - make things easier on yourself in the long run and go MD if you have the chance
ace1400
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Re: Advice on selecting medical school

Post by ace1400 »

Also an MD, with somewhat different advice...

Having been involved with some of the residency and fellowship decisions in a very competitive specialty, my perspective is that if you have the opportunity to go to a very top (Definitely Harvard, Hopkins, and Stanford, maybe UCSF, UPenn, and Wash U) medical school I think the possible extra cost is worth it.

This only applies if you are considering a competitive specialty. If you know you are heading to a noncompetitive residency, by all mean go to the cheapest med school. Put it like this: from most med schools, if you have a bad day on your USMLE Step 1 exam, you will not be getting interviews in any highly competitive specialty. You will be counseled to choose something else, and directed to a different specialty. The percentage of students who matched in one of their top three residency slots can be very misleading due to this. Harvard med students in the middle of their class with unexceptional board scores do match (at less prestigious residencies) in highly competitive specialties, while Podunk U med students are strongly discouraged from even applying in much specialties unless they are near the top of the class and have very high board scores.

At med schools with excellent departments in many specialties you would work with prominent people on each rotation, and recommendations from people that they know are looked on very favorably by residency directors. Some schools are so focused (most commonly on primary care) that it is much more difficult to get experience in other areas in a timely fashion - if all your non-primary care rotations are in the latter half of your 4th year, it is very difficult to experience a specialty and work with people who can write good recommendations, especially if the specialty is an early match.

Good luck. For all the MD negativity on this board, I love my job.

Ace

P.S. In reference to one of the comments above, Princeton doesn't have a medical school.
AnesBH
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Re: Advice on selecting medical school

Post by AnesBH »

ace1400 wrote: In reference to one of the comments above, Princeton doesn't have a medical school.
My mistake- The ENT I was referring to earned his undergrad at Princeton, his MD at Duke University.
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Re: Advice on selecting medical school

Post by necrotic »

Agree with most of above. Having participated very recently in resident candidate selection interviews and committee meetings (in what many would consider a competitive specialty -match rates are between 60-70%), I would say that sadly the DOs really didn't stand a chance. I would also say that the prestige of the school matters some (not a whole lot, but still matters some). It gives people more leeway with grades, for example: if you are middle or even lower end of the class rankings at Harvard or some other big name school, that doesn't really hurt your chances as much as it would if you came from a lower tier/less well known place. Also, the weight of a letter of recommendation increases if the letter writer is a well known, recognized authority. "Best student I've worked with in years!" means more coming from big name attendings (who tend to congregate at big name medical schools). Good letters from these high profile people can be earned on "away rotations" but there is a bit of a home team advantage. However, if you know ahead of time you want to go into one of the less competitive specialties, you should definitely pick the cheapest school. I personally picked the cheapest school I got in to (was not my state school) and that has worked out well for me.


Edit. Sorry for redundancy... Ditto what Ace said
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avenger
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Re: Advice on selecting medical school

Post by avenger »

I will also echo (being faculty in a DO program in a competitive specialty, though I am an MD) that DOs choosing a competitive specialty experience abysmal match rates. For MDs trying to get into a competitive specialty, I believe it does help to be from a top 10 medical school.
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NewEyeDoc
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Re: Advice on selecting medical school

Post by NewEyeDoc »

I'm recently out of fellowship, and now working in a private group. I went to the top Ivy League schools, training...etc, and my employer didn't care where I graduated from or where I trained. It was sort of a blow to the gut. I now have a hefty educational debt to dig out of.

I agree that going for a cheaper medical school is probably the most economically prudent decision--it ultimately depends on your ego as well. When you're a naive college kid who is offered a spot in every medical school you applied to, you figure that you should aim high.

Wished EmergDoc's book was published earlier. ;-) It'll certainly help me get my financial footing back in order...
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avenger
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Re: Advice on selecting medical school

Post by avenger »

NewEyeDoc wrote:I'm recently out of fellowship, and now working in a private group. I went to the top Ivy League schools, training...etc, and my employer didn't care where I graduated from or where I trained. It was sort of a blow to the gut. I now have a hefty educational debt to dig out of.

I agree that going for a cheaper medical school is probably the most economically prudent decision--it ultimately depends on your ego as well. When you're a naive college kid who is offered a spot in every medical school you applied to, you figure that you should aim high.

Wished EmergDoc's book was published earlier. ;-) It'll certainly help me get my financial footing back in order...
Do you think your residency program cared what medical school you went to?
cheers ... -Mark | "Our life is frittered away with detail. Simplify. Simplify." -Henry David Thoreau | [VTI, VXUS, VWITX, SV fund]
NewEyeDoc
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Re: Advice on selecting medical school

Post by NewEyeDoc »

avenger wrote:
Do you think your residency program cared what medical school you went to?
Yes, I think it did. I think it matters more if you are going into a competitive specialty and how many spots are available per year. Of course, having high board scores and a good CV probably helps the most.
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Tozmo
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Re: Advice on selecting medical school

Post by Tozmo »

Keep in mind that there are DO specialties (opthal, neurosurg, derm), though their numbers are much less than the amount of spots in the MD GME world. So going DO doesn't cut off from high powered income, if that is somehow a goal. It's like being an ice hockey goalie trying to get to the NHL. There are fewer goalies in the world, but there are fewer spots in the NHL for them also, so you have to be really good.

But being a DO trying to match into MD opth or ortho? The history of man can probably count those on one hand.
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Re: Advice on selecting medical school

Post by dhodson »

It all depends on what residency you want. When we selected residents for derm, the school mattered but that is bc everything mattered. The competition is so fierce for the very competitive residencies that you are almost forced to use any possible reason to select or deselect an applicant. As you move from ultra competitive to still fairly competitive specialties, I feel that school name will count less compared to scores, letters, grades, etc.
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Re: Advice on selecting medical school

Post by travellight »

I agree with ace1400 as well. When I hire, the top name school grads get looked at first. We care most about where you finished your training but each step leads to the next. Ten years later, no one will ask you your board scores but where you went to school still resonates. For less competitive fields, it doesn't matter much and I would go with the cheapest.
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